INFORMING THE ELDERLY AND THEIR FAMILIES ABOUT ELDER ABUSE

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My boss told me the other day that he was proud of me. He complimented me on how I managed to pursue another graduate degree, work for two law practices and care for my mother. The “old” me would have luxuriated in the praise. The “new” me realizes that I am doing exactly what I ought to do. The “old” me would have said I achieved this juggling act in spite of being a caregiver. The “new” me realizes that I achieved this juggling act because I am a caregiver.

My professional career revolves around caring and protecting the elderly. I could not, in good conscience, not do the same for my mother. As I mentioned previously, I used to browbeat myself, wondering if I am doing this right and worrying whether she feels loved and wanted .

I would like to share with you what I have learned through this journey:

Do not get caught up on who is not pitching in to help. You will drive yourself to distraction and heartbreak. Stay focused on what you are providing for your loved one. Trust me, it is appreciated.

Allow yourself to have a moment. Believe it or not, it will pass. It takes too much energy to keep up a facade.

Tell yourself the truth about your situation. Making up a story to appease yourself is lying. Period.

People are always cautioning to ask for help. They may mean well, but unless they have a working knowledge of your daily interaction with your loved one, it can turn ugly. I experienced those who tried to help. Even though it “may” not have been intentional, the “helpers” created a mess, leaving me to clean up the collateral damage when they went home.

I have been fortunate enough to work from home. Please be clear; there will be a push back. You will have to make sacrifices. People will stop by to “keep you company” knowing that you are home because you are working and you are not able leave your loved one alone. Note: As long as you are managing, those who promised to help, will not.

If someone offers you a few minutes to take a walk, take it. You will feel better and you will be able to exhale.

If you want to vent, vent to the social worker and the healthcare professionals your loved one sees. You will find that many people will not find talking about your challenges as a caregiver good conversation. I have had even family members cut the conversation short.

This may sound like shade, but I am going to say it. Unless one is in the trenches or can offer you insight from experience and/or training, their input is useless. You will be offended and may lose it.

I am not trying to scare anyone from being a caregiver. Personally, I have found it rewarding and I have grown personally and professionally. But that is my experience. My dining room is now a bedroom for my mother with a hospital bed (see picture above). I had to move her downstairs because of the stairs. Also, I now have alarms on my doors so that I can hear her when she decides to venture off or open a door when she has an episode.

I would have never imagined having a hospital bed and a commode in my home, let alone in my dining room. For many of us, this is our new normal. Be honest with yourself. If you do not feel that you can be a caregiver on a regular basis, please do not torture yourself. It is better that you tell the truth rather than to become resentful and then later abusive to your loved one.

As I always mention, please report all incidents to the proper authorities. You can also find information on the National Center on Elder Abuse’s website at http://www.ncea.aoa.gov.

It is holiday time again. In addition to the good cheer and festive demeanor, it is unfortunately a scammer’s dream. This is the time when predators seek out those senior citizens full of holiday cheer to victimize them. Research has shown that as one ages, the ability to distinguish what is realistic and what is not feasible diminishes. According to the National Association of Area Agencies on Aging, financial fraud from the elderly population costs about three billion dollars a year on average, which is a 12% increase since 2008, and in 55% of those cases, it’s perpetuated by a family member.

Most recently, according to the Cullman County Sheriff’s Office, a phone scam is making its way across the county, targeting the elderly. Chief Deputy Max Bartlett said that those receiving calls from people claiming to be grandchildren in need should be wary. “These callers say they’re in trouble and need money wired to them,” he said. Bartlett said that on Friday the sheriff’s office had two fake calls reported in less than 24 hours. The impersonators appear to target elderly people in hopes that they do not easily recognize the voice of their relatives.

The U.S. Department of Justice estimates that dishonest telemarketers take in an estimated $40 billion each year, bilking one in six American consumers — and the AARP claims that about 80% of them are 50 or older. Older adults can protect themselves by:

throwing junk mail away;

Question the caller, usually this will deter him/her from speaking further;

when you are on the internet, make sure that you are on a secure site, particularly when making online purchases;

make sure that you do not select “remember me”or the “keep me signed in” to prevent anyone from accessing your online banking or shopping accounts;

do not give personal information over the phone;

contact the Better Business Bureau if you have questions about a potential contractor;

As I always mention, please report all incidents to the proper authorities. You can also find information on the National Center on Elder Abuse’s website at http://www.ncea.aoa.gov. if you live in the Greater Philadelphia area or New Jersey, you may contact the Pile Law Firm at 610-718-6368 or http://www.pilelaw.com. Please feel free to leave your questions or comments.

Trying to take care of your aging parents is taxing but also a gift. I say it is a gift because you get to repay them for the love and nurturing that they gave you. One of the challenges with dealing with your siblings is knowing that someone with a background is equipped with the training and experience to deal with this type of issue. I had to deal with the questioning and and a sibling posturing for position, trying to prove that one sibling has more influence over my mother. I recently experience this with some of my siblings. I have to admit I was irritated.

Here I am, the trained professional, both from an academic, counseling and legal background getting angry with my younger siblings for their interference. I had everything lined up for my mother and now they had the nerve to question me! I arranged for my mother to attend a day program, see a mental health professional and my aunt convinced her to have knee surgery. I was so angry; I let them take on the responsibility to prove how right I was. Of course, the outcome was exactly as I expected. My sisters, my aunt and my boss said something to me that made me realize that I have to think about securing my mother rather than proving them wrong and incompetent. I was planning to move far away and distance myself so that they could feel the brunt of their transgression.

I was so ready to gloat about how I proved them wrong. I forgot that the real issue at hand is ensuring that my mother gets what she needs. At that moment, I realize that if I am not careful, I could have make it about me being the “expert”.

My aunt also stepped in and did a wonderful job taking care of my mother. Even with her own issues, she loved my mother enough to take care of her. This was later met with interference!

Here are some tips to keep one focused on your parents’ needs:

Pitch in- Ask what you can do to help. One sibling should not take on the whole responsibility.

Don’t criticize- If you are not helping, you are not part of the solution.

Be creative- Think of ways that are going to engage all of the siblings to help.

Stay focused- it is not about you, it is about your parents. Stay clear of the “I’ll show you” mentality. They can be the three most dangerous words in the English language. Also, if you are a professional in this field, this is not the time to flaunt your expertise.

Be transparent; communicate- I learned that you have to explain to your siblings what choices and decisions you are considering. There was an occasion when I had scheduled for a nurse to visit my mother and my mother called my younger brother to pick her up to visit. I was angry that he would pick her up after I scheduled the nurse visit. However, I did not inform him that the nurse was coming. We both realized that my mother was using him to dodge the nurse.

Do not commit if you do not know what the responsibility entails- If you do not have the time and patience to take care of your parents’ needs and your other siblings do, let them.

Love is not being passive- You have to be willing to make the tough decisions to help your parents. You have to know your limitations. My younger siblings thought that having my mother at home with them would help her. They later realized that they were ill equipped to give her what she needed.

DO NOT TRY TO DIAGNOSE YOUR PARENTS. – One must get a proper diagnosis from a trainer professional.There are many similar symptoms

As I always mention, please report all incidents to the proper authorities. You can also find information on the National Center on Elder Abuse’s website at http://www.ncea.aoa.gov. Please feel free to leave your questions or comments.

Robin Williams’ suicide should serve as a wake up call for many of us who did not understand how depression affects older adults. It is estimated that 6.5 million of the 35 million adults over the age of 65 suffer from depression. This seems to be, in many instances, attributed to loss of independence, acknowledgment of one’s mortality, disability and loss. In the case of Robin Williams, it is speculated that his Parkinson’s diagnosis may had been a factor in his decision to commit suicide.

The Center for Elderly Suicide Prevention reported that the rate of suicide for the elderly for 2007 was 14.3 per 100,000. White men over the age of 85, were at the greatest risk of all age-gender-race groups. In 2007, the suicide rate for these men was 45, 42 per 100,000.

According to the Center for Disease Control, suicide rates among older adults is believed to under-reported. In fact, men in their 50’s and early 60’s (Robin Williams’ age bracket), the rates have increased. It is interesting to note that though young people make more suicide attempts, older adults are more successful in carrying it out. This is a result of the lack of the physical acumen they once possessed.

Depression seems to be the most causal symptom of suicide among this group. Also, the fear of appearing helpless, not feeling valuable or wanted also leads older adults to comtemplate suicide. It is so important that family members and friends observe signs of depression and social isolation. Here are some warning signs from the American Association of Marriage and Family Therapists (AAMFT):

Loss of interest in things or activities that are usually found enjoyable

Cutting back social interaction, self-care, and grooming

Breaking medical regimens (such as going off diets, prescriptions)

Experiencing or expecting a significant personal loss (spouse or other)

Putting affairs in order, giving things away, or making changes in wills

Stock-piling medication or obtaining other lethal means

Other clues are a preoccupation with death or a lack of concern about personal safety

Remarks such as “This is the last time that you’ll see me” or “I won’t be needing anymore appointments” should raise concern.
The most significant indicator is an expression of suicidal intent.

As I always mention, please report all incidents to the proper authorities. You can also find information on the National Center on Elder Abuse’s website at http://www.ncea.aoa.gov. Please feel free to leave your questions or comments.

References:
American Association of Marriage and Family Therapists
Center for Disease and Control
Center for Elderly Suicide Prevention

When one realizes that their parent is starting to exhibit signs that they need help, decisions must be made. It is probably the most tragic thing to witness. To think that this person that raised you into an adult is now is need of care is heartbreaking.

Many times the parent is in denial and will become obstinate and refused to admit help is needed. I have learned that you cannot engage in an argument. You must first have empathy for the hand that was just dealt to them.

The very idea of relying on someone for assistance for a parent is scary. That parent is being asked to take a risk and let someone intervene in decisions that they have made years prior. As an adult child, you must understand their plight and also help that parent feel a sense of independence and pride.

Dr. Rob Crankshaw made this suggestions:

Give elderly parents every opportunity to continue to make their own decisions. It may take a crisis, but at some point it will become clear to all involved that a change in level of care is necessary. Hopefully the crisis will not result in permanent physical damage.

Recognize that sweeping changes may not be necessary. Sometimes smaller modifications like Occupational Therapy or a change in medication may be all that is needed. (that was hard for me because I became fixated on making it work now).

Be aware of your parent’s possible feelings of embarrassment, shame and impotence as more decisions are made for them. Use humor, self-deprecation, and a positive outlook to help the elderly from focusing on their loss of independence. Find a positive side of any negative occurrence without belittling what elders are going through (this may be the most important suggestion).

We forget, during our pubescence, our parents would become objects of embarrassment. We did not walk them to walk us to school or show public displays of affection. Our parents, despite their hurt, took it on the chin knowing that we were trying to become independent. I would encourage adult children to remember that image and exercise patience with your aging parents.

I also caution adult children that if they need support to seek it out. Adult children who become frustrated often turn into becoming abusive to their parent. Share the load with your siblings, if you have them.

I want to add something I heard watching the Queen Latifah Show. Swoosie Kurtz, the famous Broadway, movie and TV star, is taking care of the mother. Her mother has a “touch of dementia”, as she refers to it. One day her mother asked her if she was in the way. Her response was, “no mom, you are the way.” To me, that says it all.

As I always mention, please report all incidents to the proper authorities. You can also find information on the National Center on Elder Abuse’s website at http://www.ncea.aoa.gov.

June 15, 2014 is World Elder Abuse Awareness Day. This day was created in 2006 by the International Network for the Prevention of Elder Abuse and the World Health Organization at the United Nations. The very idea behind WEAAD was to promote a better understanding of abuse and neglect of older persons. It was intended to show that this health concern is a global concern regardless of race, culture, social or economic status.

In the past, many communities groups developed educational programs or press conference, organizing visits to the elderly and writing articles in local newspapers. Here are some facts about elder abuse from a global perspective:

In many parts of the world, elder abuse occurs with little recognition or response. Until recently, this serious social problem was hidden from the public view and considered mostly a private matter.

Elder abuse is a problem that exists in both developing and developed countries yet is typically underreported globally. Prevalence rates or estimates exist only in selected developed countries ranging from 1% to 10%.

Around 4-6% of elderly people have experienced some form of maltreatment at home.

Elder maltreatment can lead to serious physical injuries and long-term psychological consequences.

Elder maltreatment is predicted to increase as many countries are experiencing rapidly ageing populations.

The global population of people aged 60 years and older will more than double, from 542 million in 1995 to about 1.2 billion in 2025.

As I always mention, please report all incidents to the proper authorities. You can also find information on the National Center on Elder Abuse’s website at http://www.ncea.aoa.gov.

One of the hardest decisions an adult child/children must make is whether or not to place their parent(s) into a nursing home. There are feelings of guilt and failure attached to such a major decision. This is why careful analysis of this life-changing decision is important. Many decide to keep their parents at home because they feel that it is the right thing to do. However, there are some important considerations.

Many elderly loved ones want to remain at home because of the memories attached to belongings and their residence. They also have a sense of community with long-time neighbors. However, there are issues that may be of concern such as cooking, cleaning, toileting, shopping, doing laundry, and driving, as well as falls, which for frail elders could prove to be problematic.

One has to ask oneself if family members, friends, or neighbors will be available to take care of the specific thing the elder has trouble with — such as doing laundry or shopping. Also, someone must be available to accompany the elder to doctor appointments and other appointments. The elder may need assistance in maintaining the residence and paying bills timely.

If one chooses to become a caregiver, they are some dangers for the caregiver to contemplate. According to http://www.webmd.com, caregiver burnout is a serious problem. It is a “state of physical, emotional, and mental exhaustion that may be accompanied by a change in attitude — from positive and caring to negative and unconcerned.” This a result of a caregiver don’t get the help they need, or if they try to do more than they are able — either physically or financially. Guilt and inadequacy are the final result. Here are the symptoms:

Withdrawal from friends, family, and other loved ones

Loss of interest in activities previously enjoyed

Feeling blue, irritable, hopeless, and helpless

Changes in appetite, weight, or both

Changes in sleep patterns

Getting sick more often

Feelings of wanting to hurt yourself or the person for whom you are caring

Emotional and physical exhaustion

Irritability

Scott Eckstein was an Executive Director of an Assisted Living Facility for 20 years. He has witnessed many adult children in tears about the challenges of being a caregiver. He suggests the following:

Find a support group or network. You may be surprised how many are out there and how many people are in the same boat as you. Attend some meetings to receive feedback and learn coping strategies. Find the meeting that is a fit for you. Openly share your feelings and experiences with others.

Strongly consider speaking with someone you trust. Bottling all your tension up can lead to angry outbursts. It’s always good to hear things from an outside perspective, especially from someone not directly involved in your situation.

See your doctor or another professional to explore the burnout issues that are impacting you specifically.

If possible, vary the caregiving responsibilities. Rotate/share responsibilities with family members — demand it! It’s really okay to ask for help. You have to accept the fact that you cannot do everything yourself, otherwise you’ll end up being the one that needs to be cared for.

Put time into taking care of yourself emotionally and physically. Be sure to get enough sleep, maintain a healthy diet and get some sort of exercise each day.

Make room for “Quiet” or “Me Time”. Meditate, get a massage, see a movie — whatever does it for you. Just do it!

Stay involved in hobbies or other outside interests. All work and no play…you have heard it. It applies to care giving too.

Acknowledge caregiving is filled with stress and anxiety. Understand the potential for burnout. As a caregiver, you need to be on-guard against succumbing to burnout. It may be cliché, but it cannot be said often enough: “The best way to be an effective caregiver is to care for the caregiver.”

Why does this require careful consideration? Studies have shown that loving caregivers can become abusers if they do not take care of themselves first in order to be effective and loving caregivers. To those who are caregivers of older loved ones, you are charged with the responsibility of helping them maintain their quality of life.

As I always mention, please report all incidents to the proper authorities. You can also find information on the National Center on Elder Abuse’s website at http://www.ncea.aoa.gov.